DEAR DR. DONOHUE: My daughter is 52 and has been on medication for high blood pressure for 20 years. She said her blood pressure today was 140/90. Surely there must be things she can do to bring her pressure down besides taking pills. Your help would be appreciated. – M.C.

ANSWER: Everyone can lower blood pressure without medicine, but not everyone can lower it to an acceptable level. However, it’s worth a try.

Weight loss always brings down pressure. A weight loss of 22 pounds can lower pressure by as much as 20 points. Even a slight weight loss puts a dent in blood pressure and eases the burden on the heart and arteries.

A change in what a person eats is another way to lower blood pressure. The DASH (dietary approaches to stop hypertension) diet has been proven to reduce pressure. This diet is one where the main foods are fruits, vegetables and whole grains. Nuts, poultry and fish are other foods in this diet. Red meat is minimized.

Salt reduction can reduce pressure. The maximum amount of sodium (salt) in the diet is 2,400 mg, about 1 teaspoon. A preferable goal is 1,500 mg. Although salt added during cooking and at the table ought to be reduced or eliminated, the amount of salt obtained in those ways constitutes only 10 percent of daily salt. Most salt comes in processed foods, frozen foods, commercial soups, luncheon meats and breakfast cereals. Searching food labels for sodium content has to become a habit.

Increasing daily potassium diminishes blood pressure. Fruits like bananas and oranges are good sources of potassium. So are beans, raisins, sweet potatoes, spinach and baked potatoes with skin.

A half-hour of exercise every day is another pressure-lowering measure. A brisk walk is fine.

Alcoholic drinks should be limited to two a day for men and one a day for women.

DEAR DR. DONOHUE: What kinds of blood pressure pills are most likely to cause erectile dysfunction? Please name some medicines that don’t create this problem.

Why would any doctor be lowdown enough to prescribe a drug that causes erectile dysfunction when there are choices that don’t cause it? – B.R.

ANSWER: You’re upset for the wrong reason. Practically every class of blood pressure medicine can cause some men to have trouble with erectile dysfunction. If only those medicines that aren’t implicated in the possible side effect of ED were prescribed, blood pressure medicine costs would soar, and other, even more dire side effects would be rampant.

Water pills, calcium-channel blockers, beta blockers and ACE inhibitors have all been blamed for causing ED. These are the most reasonably priced and usually most effective blood pressure medicines. ARBs – angiotensin receptor blockers – are less likely to be a cause of ED. Two examples are Benicar and Diovan. The newest blood pressure medicine, Tekturna, has not been demonstrated to be a factor in ED, but it’s so new that reports of ED might not have yet trickled in.

DEAR DR. DONOHUE: Please help me. I am a very active 70-year-old man. My new doctor decided that my blood pressure was too high and started me on medicine. To get into his office, you have to walk up a hill, deal with signing in – and then your pressure is immediately taken. The medicine made me so tired that I could not move. The doctor had me get a home blood pressure unit, and it is accurate. At home my pressures are 125-135/65-75. Does this require treatment? – J.K.

ANSWER: Blood pressure should not be taken until the patient has rested comfortably in a chair for five minutes. Furthermore, home readings are a better gauge of what true blood pressure is than is office pressure. Normal pressure is below 120/80; high blood pressure is equal to or greater than 140/90. Numbers in between are “prehypertension” and usually do not call for medicine treatment.

DEAR DR. DONOHUE: How soon after taking medicine is it OK to drink alcohol? I say an hour is enough time. My wife thinks it should be four hours. Who is right? – B.N.

ANSWER: First you should make sure your medicine is compatible with alcohol. Some medicines aren’t. In that case, you shouldn’t drink alcohol at all while taking the medicine.

It takes the stomach about four hours to empty its contents. Medication, however, doesn’t stay in the stomach for that long.

If your medicine is compatible with alcohol use, the answer is a compromise: You should be safe if you wait about two hours after taking it.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com